How to achieve fast claims ?Let s take a look at the whole process of Xinhua Insurance s intelligen

Mondo Finance Updated on 2024-01-30

Technology empowerment makes claims service faster and more warm. New China Insurance has long practiced the service connotation of "fast claim settlement, excellent service", created a full-process intelligent claims service system, enriched the supply of insurance services, and brought customers a simplified, ultimate and fast service experience.

Technology empowerment has speed: nearly 80% of cases can be completed on the same day

New China Insurance has actively built an intelligent claims service system covering the whole process of "insurance-reporting-application-review-payment", which effectively solves many pain points in the traditional claims process.

At the same time, claims consultation**, claim process, claim progress, claim conclusion, etc. can be queried in real time through official WeChat, official website, official APP and other platforms, so that the claim can be "seen" and the guarantee "touched", so as to achieve transparent claim settlement and abide by service commitments.

Accident - reporting stage: support 95567 + official WeChat + counter and other multi-channel reporting methods, to provide customers and salesmen with 7*24 hours, online and offline professional consulting services. At the same time, the claims service specialist will pay regular visits to guide customers to apply for claims.

Application stage: Customers can submit a claim application anytime and anywhere through the "WeChat Self-service Claim for Individual Customers", with no limit on the amount of bills, and cases that meet certain conditions can be exempted from submitting paper documents, or they can contact the policy service staff to sign for the claim, and they can submit the claim application one step ahead of others without leaving home.

At the same time, Xinhua Insurance realizes the direct connection with the information system of hospitals in some regions through the data platform, and after obtaining the authorization of the customer, the company retrieves and transmits the relevant diagnosis and treatment, settlement and list information of the docking hospital in real time through the data platform, and the system responds basically in seconds, so that customers can enjoy the claim service one step faster. The service currently covers 575 hospitals in 5 cities (Hefei in Anhui Province, Zhengzhou in Henan Province, Dezhou in Shandong Province, Zibo in Shandong Province, and Xiamen in Fujian Province).

Review stage: The company actively builds an AI claim intelligent review system to improve the efficiency of claim review.

Payment stage: The scope of real-time payment of insurance money has been extended to all cases with an insurance amount of less than 10,000 yuan (inclusive), and nearly 80% of the cases can be completed on the same day, which significantly shortens the transfer payment cycle and enhances the customer's sense of gain.

Thoughtful and warm service: provide condolences for critical illness and first compensation, medical advance, and direct payment for special drug purchases

New China Insurance continues to establish and improve a package of health management service systems covering domestic and overseas service scenarios and different health management needs before, during and after medical treatment, providing customers with the last "1 kilometer" solution for their medical expenses, and continuing to provide critical illness condolences and advance compensation, medical advance payment services, and direct payment services for special drugs (including CAR-T) drug purchases.

From the perspective of customers, New China Insurance allows customers to truly enjoy the peace of mind, peace of mind and comfort of claims settlement by exploring a variety of new claims service models such as consultation with external experts and grading appraisal of claims.

Critical illness condolence and first compensation service. In order to enable customers who unfortunately suffer from malignant tumors to receive professional claim guidance in the early stage of illness and alleviate the financial pressure on customers seeking medical treatment, Xinhua Insurance has launched the "Critical Illness Condolences and Compensation Service", and provides "Three Ones" quality services: one-to-one condolences and assistance, priority handling of green lights all the way, and one-day claim conclusion. From January to October 2023, New China Insurance has completed more than 4,600 claims nationwide, with a total amount of about 3900 million yuan, so that critical illness customers can truly feel the speed and temperature of Xinhua Insurance in the process of claim settlement.

Medical advance services. From January to October 2023, medical advances benefited 335 customers, with a total amount of 11.56 million yuan, of which about 350,000 yuan, with a maximum amount of 240,000 yuan in a single advance.

Direct payment service for special drugs and CART medicines. New China Insurance has launched related health management services such as special drug purchase and CAR-T drug purchase direct payment service, allowing customers to enjoy advanced medical technology while simplifying drug purchase and claim procedures, and experiencing the convenience and intimacy of claim settlement. Among them, there were 2 cases of special drug insurance customers (11 times of direct payment of compensation, with a total of 26 insurance benefits530,000 yuan).

Consultation with external experts. For difficult dispute cases, in line with the original intention of "finding reasons for compensation for customers", New China Insurance hired experts from domestic authoritative tertiary hospitals to conduct consultations with deputy chief physicians and above, so as to improve the accuracy of claim conclusions and effectively protect the rights and interests of customers.

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